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Law 5: Soccer Referee Instructions for Player Injuries

Law 5 from the IFAB Laws of the Game establishes the basic principle that, if a soccer referee stops play because a player had been judged to be seriously injured, that player is required to leave the field for treatment and may not return to the field (assuming the player is not substituted) until after play has been restarted and only with the permission of the referee. In 2012, US Soccer Federation's guidance on this matter, based on interpretations provided by the International Board, establishes the following additional information:

The goalkeeper is exempt from this requirement.

A player who is injured may still be required to leave the field if the referee beckons medical assistance onto the field at a stoppage called for some other purpose.

A player who leaves the field -- with the permission of the referee, for treatment of an injury without having assistance beckoned on or for whose injury play has not been stopped -- may return before play is restarted, provided the player receives the permission of the referee.

The goalkeeper exemption from the requirement to leave and not return until after play has resumed was extended to include any field player (from either team) who may have been injured with the goalkeeper in a common collision. This exemption was extended in 2010 to include any two (or more) players injured in a common collision if they are from the same team.

Questions have been raised regarding different variations of these basic scenarios. The purpose of this paper is to resolve these issues in a clear, understandable way by providing a chart of the possible variations and the correct referee response to each. Before doing so, however, one significant point must be emphasized. When the International Board stated the "common collision" exemptions, it was assuming (without stating it explicitly) that all persons involved in the collision were seriously injured. Unless there was a serious injury, there would have been no requirement to leave the field in the first place and thus there would not be any need for an exception.

The scenarios below are based on two persons only. Extending the chart to include collisions involving more than two would have complicated the chart unnecessarily because there is no fundamental difference in the proper action to take for collisions involving three or more players than for collisions involving just two players. In all cases below, the referee has stopped play solely for at least one injury which has been deemed serious.

Correct Actions To Take In Regard To Player Injuries

Goalkeeper and Field Player, both seriously injured:Both permitted to receive treatment on the field and to remain on the field.

Goalkeeper and Field Player, only Goalkeeper seriously: Goalkeeper permitted to receive treatment on the field and to remain on the field. Field player remains on the field.

Goalkeeper and Field Player, only Field Player seriously: Field player required to leave the field to receive treatment, cannot return until after play resumes and only with the permission of the referee.

Two Field Players (Same Team), both seriously injured: Both permitted to receive treatment on the field and to remain on the field.

Two Field Players (Same Team), only one seriously injured:The seriously injured field player is required to leave the field to receive treatment, cannot return until after play resumes and only with the permission of the referee. The other field player not seriously injured remains on the field.

Any field player or goalkeeper who is not required to leave the field may still do so with the permission of the referee and is allowed to return prior to the restart of play with the permission of the referee. Where a goalkeeper requests permission to leave, play may not be resumed without another goalkeeper either substituted or identified from among the field players.

Any player whose injury is deemed "severe" may receive emergency treatment on the field, but it is expected that the severity of the injury would require the player eventually to leave the field with no likelihood of returning for the balance of the match.

Any player other than a goalkeeper who has been seriously injured, whether required to leave the field or not as described above, will nevertheless be required to leave the field if bloodied and/or bleeding (regardless of whether the blood or bleeding is the result of an injury). Such a player may not return to the field until and unless an inspection of the condition is conducted by the referee, or by another official designated by the referee, to determine that the situation has been corrected. If the blood or bleeding is not the result of a serious injury, the player may return to the field before play resumes; otherwise, the player must wait for play to resume and then request the permission of the referee to return. A seriously injured and bleeding goalkeeper may have both conditions treated on the field.

Game Scenarios

Blue #13 and Blue #5 collide and the referee stops play based on the determination that both players are seriously injured. Both players may remain on the field while treatment is provided and neither is required to leave. Blue #5, however, requests permission to leave the field to change a uniform item torn in the collision. Blue #5 can leave the field and, with the referee’s permission, can return to the field before the restart of play.

The Red goalkeeper and Blue #11 collide and the referee stops play based on the determination that the goalkeeper is seriously injured. The goalkeeper is bleeding as a result of the injury. The goalkeeper is allowed to stay on the field and have both the injury and the bleeding attended to (but the bleeding condition must still be inspected by an official to confirm that the problem has been corrected). Blue #11 is not required to leave the field.

Red #44 and Red #51 collide and the referee stops play after determining that only Red #44 is seriously injured. Red #44 is required to leave the field and may not return, except with the referee’s permission and not until after play has been restarted. Red #51 remains on the field.

Red #44 and Red #51 collide and the referee stops play after determining that only Red #44 is seriously injured. However, after stopping play, the referee decides that Red #51 needs medical attention and beckons the team’s trainer onto the field. Since this action normally triggers the requirement to leave the field, both Red #44 and Red #51 are now allowed to remain on the field and receive treatment.

Red #55 collides with the Blue goalkeeper and the referee determines that only Red #55 was seriously injured. Red #55 is required to leave the field and may not return, except with the referee’s permission and not until after play has been restarted.

Blue #34, Blue #51, and Red #17 collide and the referee stops play based on the determination that Blue #51 and Red #17 are seriously injured while Blue #34 is only slightly injured. Blue #51 and Red #17 are each required to leave the field and neither may return, except with the permission of the referee and not until after play is restarted.

The Blue goalkeeper collides with a teammate, Blue #46, and the referee stops play after determining that both players are seriously injured. Additionally, Blue #46 is bleeding at the forehead from the contact. Both players are allowed to be treated on the field for their injuries but Blue #46 must leave the field to correct the bleeding problem (and may also receive treatment for the injury off the field): Blue #46 may be allowed to return to the field, with the permission of the referee, before the restart of play, provided the bloodied jersey problem has been corrected and inspected.

Red #15 collides with Blue #39 and the referee stops play after determining that both players are seriously injured. Accordingly, both would normally be required to leave the field for treatment but the referee, on closer inspection, decides that the injury of Blue #39 is severe. Red #15 is still required to leave the field but Blue #39 may receive treatment while still on the field. However, Blue #39 is removed from the field after emergency first aid is given and an ambulance arrives to transport the player to the hospital. Red #15 must wait for the resumption of play before requesting the referee’s permission to re-enter the field.

Referees are reminded by the United States Soccer Federation that the correct actions described above are based on the Laws of the Game and existing official guidelines and interpretations. They are not dependent on the age of the players or the competitive level of the match. However, decisions as to whether an injury is serious or severe are and must be highly influenced by such factors and, in any questionable case, the referee should decide in favor of protecting the safety of the players.